Finding a Behavioral Health Specialist Who Accepts Insurance: Why Is It so Difficult to Access Mental Health and Substance Use Disorder Providers?

For individuals with health insurance, accessing in-network behavioral healthcare is often frustrating. Psychiatrists and psychotherapists listed on a health plan’s website as participating providers turn out not to be in the network or are not accepting new in-network referrals. Patients are often forced to see an out-of-network specialist or rely on their primary care provider for behavioral healthcare. Employers are frustrated by the loss of productivity that follows poorly treated or untreated psychiatric disorders in the workforce. Health plans are increasingly concerned about the higher cost of care for members with comorbid behavior health and medical conditions. All of the principal stakeholders would appear to have similar incentives and goals. So why doesn’t the system work?

The three panelists will present their views on barriers to accessing behavioral healthcare as well as current approaches to breaking down those roadblocks. The audience will have an opportunity to hear about the work of psychiatric and other medical professional associations, legislative advocates, and groups that seek to bring all stakeholders to the table to work out solutions, including employers and health plans.

The evening promises a lively discussion with ample opportunity for audience participation.

Panelists

Henry Harbin, MD, is a psychiatrist with over 40 years of experience in the behavioral health field. He has held a number of senior positions in both public and private health care organizations. He worked for 10 years in the public mental health system in Maryland during the 1980s, serving as Director of the state mental health authority for three of those years. Between 1994 and 2004 he was CEO and Chairman of two national behavioral healthcare companies, Greenspring Health Services and Magellan Health Services. In 2002 and 2003 he served on the President’s New Freedom Commission on Mental Health and was chair of the subcommittee for the Interface between Mental Health and General Medicine.

Dr. Harbin has also assisted the Parity Implementation Coalition, a group of 13 national behavioral organizations including the American Psychiatric Association, NAMI and Mental Health America, that advocate for implementation of the Federal Mental Health Parity Law.

Rachel A. Fernbach, Esq. is Deputy Director and Assistant General Counsel of the New York State Psychiatric Association, the medical specialty association of psychiatrists practicing in New York and a division of the American Psychiatric Association.

Ms. Fernbach provides legal and policy guidance to member psychiatrists on federal and state statutory and regulatory requirements. She regularly advocates with government regulators and third party payers on behalf of members in connection with coding and billing issues, mental health parity issues and other issues of importance to psychiatrists and their patients. Ms. Fernbach is a graduate of Tufts University and The George Washington University School of Law. She is admitted to practice law in New York and New Jersey.

Bruce Schwartz, MD, is currently the Deputy Chairman, Clinical Director and a Professor of Psychiatry in of the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center and the Albert Einstein College of Medicine.  Dr. Schwartz serves as the President of the Montefiore Behavioral Care IPA and is the Medical Director and founding member of University Behavioral Associates, a behavioral health management services organization.

Dr. Schwartz has a national reputation in behavioral health service delivery.  He is a member of numerous organizations including the American Psychiatric Association for which he is the President-Elect.  He has served as APA Treasurer, past-Chair of the APA’s Committee on Reimbursement for Psychiatric Care and Council of Healthcare Systems and Financing. He is a member of the New York Academy of Medicine’s Committee on Admission and Membership, past-Chair and member of the American Hospital Association’s Governing Council of the Section for Psychiatric and Substance Abuse Services.  He currently chairs the Vibrant Emotional Health (formerly the Mental Health Association of NYC) Professional Advisory Board and serves on the Board of Directors.

Dr. Schwartz is the past editor-in-chief of the American Journal of Psychotherapy and Program Director of the Annual Chief Residents (“Tarrytown”) Leadership Conference. He is a Distinguished Life Fellow of the American Psychiatric Association, member of the American College of Psychiatrists and New York Psychiatric Society. Dr. Schwartz is regularly selected by Castle Connolly’s Top Doctors and by New York Magazine as a Best Doctor.